Provider Demographics
NPI:1841207404
Name:CLEMONS, DAVID RUSSELL (PSYD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:RUSSELL
Last Name:CLEMONS
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4131 SPICEWOOD SPRINGS RD STE E1
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-8658
Mailing Address - Country:US
Mailing Address - Phone:512-825-3283
Mailing Address - Fax:512-640-4337
Practice Address - Street 1:4131 SPICEWOOD SPRINGS RD STE E1
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8658
Practice Address - Country:US
Practice Address - Phone:512-825-3283
Practice Address - Fax:512-640-4337
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2025-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX30534103T00000X, 103TF0000X, 103TC1900X, 103TA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)